Basic M-P Info
Prevalence of schizophrenia in your future clerkship patient population
What is 0.5-1%?
Common physical side effect that causes sexually active patients to stop taking SSRI's
Sexual side effects (ER, inorgasmia, decreased libido, etc.)
Do diabetes patients with mental health conditions receive standard levels of diabetes care?
No. They receive far less monitoring, and thus are at risk of prolonged exposure to elevated blood glucose levels, which can, among other things, cause visual impairment + blindness, damage to kidneys with the potential consequence of renal failure, and nerve damage
People with which mental health diagnosis have a 50% greater risk of CVD than the average population
Depression
Class of psychiatric medication to be avoided during acute delirium unless 2/2 alcohol
What are benzodiazepines?
The following medical conditions might resemble which psychitric illness?
adrenal disorders, CNS infections, mass lesions in brain, stroke, MS, SLE, hyperthyroidism, Parkinson's Disease, Wilson's disease, Steroid tx
What is Mania
SSNRI (selective serotonin-norepinephrine reuptake inhibitor) to be avoided in patients with high or labile Blood Pressure
Venlafaxine (Effexor)
This syndrome affects many people receiving antipsychotic meds for schizophrenia, bipolar or depression treatment. Name it and list some of its characteristics.
What is Metabolic Syndrome:
1. central obesity 2. hypertension 3. dyslipidemia 4. glucose intolerance 5. insulin resistance
Name 4 diseases higher in people with schizophrenia than the average population
Obesity, Diabetes Mellitus, Cardiovascular disease, coronary heard disease, Cerebrovascular disease, Sudden cardiac death
Treatment option for MDD with psychotic features refractory to antipsychotics and antidepressents or unable to tolerate or comply with medications, or safe for sig depression during pregnancy if mother doesn't want to take medications
What is ECT?
What happens when a patient taking psychotropic medications drinks alcohol?
What is additional/combined CNS depression
Name 2 antipsychotics you would consider using in a patient who presents with HTN, increased insulin levels, excess body fat around waits, abnormal cholesterol levels, and a hx of tardive dyskinesia
Aripiprazole (Abilify)
Ziprasidone (Geodon)
The prevalence of Diabetes Mellitus Type II in which mental illness is 3-5 times higher than the general population
Schizophrenia.
World Psychiatry. 2011 Feb; 10(1): 52–77.
Physical illness in patients with severe mental disorders.
MARC DE HERT,1 CHRISTOPH U. CORRELL,2 JULIO BOBES,3 MARCELO CETKOVICH-BAKMAS,4 DAN COHEN,5ITSUO ASAI,6 JOHAN DETRAUX,1 SHIV GAUTAM,7 HANS-JURGEN MÖLLER,8 DAVID M. NDETEI,9JOHN W. NEWCOMER,10 RICHARD UWAKWE,11 and STEFAN LEUCHT12
What % of people with schizophrenia are not being adequately screened and treated for dyslipidemia and hypertension
up to 88% untreated for dyslipidemia
up to 62% untreated
Which antipsychotics cause the most weight gain?
Clozapine + Olanzapine
Name 3 medications used to stabilize mood that can also prevent seizures
Valproic Acid (Depakote/Depakene/Valproate)
Carbamazepine (Tegretol)
Lamotrigine (Lamictal)
Oxcarbazepine (Trileptal)
How much higher is the incidence of DKA (Diabetic Ketoacidosis) is in those with Schizoprhenia compared to the general population
=> 10-fold greater.
and the mortality due to DKA is 10x higher in this population!
World Psychiatry. 2011 Feb; 10(1): 52–77.
Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care
MARC DE HERT,1 CHRISTOPH U. CORRELL,2 JULIO BOBES,3 MARCELO CETKOVICH-BAKMAS, et al
List 6 diseases/medical issues are patients with serious mental illness at higher risk for than the general population?
HIV, Hep B, Hep C, Respiratory infections, Tuberculosis, mechanical ventilation, acute Respiratory failure, pneumonia, COPD, low bone mineral density, dental issues, obstetrical complications,
Name one antipsychotic that can be considered weight-neutral
None
Name 2 categories of medications used in cancer treatment can cause mania?
Steroids, Chemotherapeutic agents
The mortality risk for Cardiovascular Disease (CVD) is 35% - 250% higher among persons with this disorder spectrum compared to the general population
Bipolar spectrum disorders
Of the following medications, which 4 have been associated with reported cases of torsades de pointes: tricyclics, SSRIs, lithium, haloperidol, olanzapine.
Haloperidol, olanzapine, and tricyclic ADs,
With SSRIs, have been associated with QTc prolongation, but no cases of torsades de pointes. There are no reported cases of lithium-induced torsade de pointes.
Name 2 antipsychotics that lower the risk of seizure threshold
Clozapine, Olanzapine